Tuesday, September 23, 2008

Is anyone going to this? (Somehow I'm always the last to know). It's not only for pumpers, but that's who this particular message was going to.

What happens to children with type 1 diabetes who outgrow diabetes camp or their pediatric endocrine team? Diabetes Solutions of Oklahoma (DSOK), a non profit organization, is offering an exciting opportunity for young adults, age 21-40, who have type 1 diabetes. DSOK is hosting a conference Nov. 7-8, 2008, for young adults with type 1 diabetes at the NCED Conference Center in Norman, Oklahoma. This is the EXTREME Diabetes Makeover.

The goal of the conference is to tear down old ideas and negative attitudes about diabetes, build a framework for a healthier life, and redesign and style diabetes to fit peoples' lives. This is the age group who is most disconnected from other people with diabetes. This conference will address the need for socializing with otherindividuals facing the same daily struggles. It is designed for anyone who must fight the daily struggles of type 1 diabetes management. As insulin pumpers, you have the greatest tool available to help you manage your diabetes. However, as you well know, successful diabetes management is 20% knowledge and 80% attitude and outlook.

Special guests include actor and comedian Tom Parks, who also has type 1 diabetes, and Dr. William Polonsky from the Diabetes Behavioral Institute of Southern California and author of the book, Diabetes Burnout: What to Do When You Can't Take It Anymore. For more information or to download a registration brochure, please visit http://www.dsok.net or call Diabetes Solutions at (405) 843-4386. What have you got to loose? Check it out and sign up soon, space is limited!

Wednesday, September 10, 2008

What induces perfectly logical people to think the human body is like a simple engineering problem? Yes, on some level, you put something in and get something out. But is it always the same? Then why do people think Type 1 diabetes is the same way? You put something in and always get the same results. If you get a bad result, you did something wrong.

Even doctors do this, which still astounds me (although it probably shouldn't). They think diabetes should be easy to control. Oh, and even diabetes doctors do this. I read the following in a book about managing mainly Type 1 diabetes (which I'm not going to name here but my version says 2006): If you take insulin, then tests must be made at least three times a day - before breakfast, dinner, and bedtime. In times of stress or illness, add a fourth test, before lunch. There's rarely a need to do it more often than that. Right! Because blood sugar is always completely predictable, am I right? It goes on to note: To complicate your life, here's more advice. To determine whether you are taking enough very fast-acting insulin such as Humalog, NovoLog, or Apidra before each meal, for a couple of days check your blood again two hours after lunch, dinner, and bedtime to see if you're in the ballpark. That sounds like a lot of tests. Good thing it's only for a couple days. The book reassures: On the other hand, some compulsive patients insist on checking their blood sugar as often as five or six or seven times a day and taking insulin accordingly. This is not necessary. Oh, great, I can stop checking so much and just expect my body to behave in a completely predictable fashion. Surely insulin-to-carb ratios and basal rates will never change, right? There's no such thing as bg going wacky due to illness, stress, hormones, the diabetes fairy. Only crazy people would think so! (The book continues with such gems as one should NEVER eat sugar, even children, and that insulin doesn't need to be refrigerated).

See how easy it is? We should all throw out testing more than three times a day, adjusting insulin, basal testing, insulin pumps. Forget it! All you need to is take the same amount of insulin and eat the same amount of carbs per meal, and you'll always be fine!

Well, as we all (hopefully) know that this isn't true. If I (with LADA) can't get good control without testing 8 times a day, I don't know how anyone else could. I eat the same breakfast every day, and have for at least three years. So do I get the same result every day? Of course not. I can look for the patterns, of course, but some mornings I'm going to need a correction, and others I might even end up low, without changing any of the other factors. So every time you have a situation, you act, the dice roll, and while you can increase the probability of an outcome, there's no guarantee you're going to get the result you want. I do think that following the advice above will lower the probability significantly. But even if you "do everything right," get educated, pick up the latest tools - you're still subject to the whims of the dice, or the diabetes fairy.

What's weird is that even when it *is* predictable, people still don't get it. "Why is your blood sugar low?" Well, guys you told me I couldn't eat anything for 12 hours and then made me walk 1/4 mile to the lab and fill out a bunch of paperwork. I could see that coming a mile away. "Why is your blood sugar high?" Well, I was planning to go shopping, so I took less insulin with lunch, but for some reason you decided you didn't want to. "Why don't you start eating right away? It makes me really uncomfortable." Well, I have to wait for the insulin to kick in, and I'm not going to take it before the food comes because I have learned my lesson there. "Why did you get upset after I stole half the food off your plate after I told you I didn't want any? That's rude!" (Left as an exercise for the reader).

Anyway, back to another day of rolling the dice and wishing for a +12 Stick of Clue.